Department of Immunology, School of Basic Medical Sciences, Fudan University, Shanghai, China.
Key Laboratory for Biotechnology on Medicinal Plants of Jiangsu Province, School of Life Science, Jiangsu Normal University, No. 101, Shanghai road, Xuzhou, 221116, Jiangsu Province, People's Republic of China.
Mol Neurobiol. 2018 Jan;55(1):718-726. doi: 10.1007/s12035-016-0346-9. Epub 2016 Dec 21.
Inflammation plays a crucial role in the pathogenesis of stroke. This study aims to determine lipoprotein (a) [Lp(a)] levels in serum and to investigate their associations with stroke recurrence events in a 3-month follow-up study in patients with acute ischemic stroke (AIS). Serum Lp(a) levels were determined in 203 ischemic stroke patients and 120 normal controls at admission. The severity and clinical outcome of ischemic stroke patients were evaluated by the National Institutes of Health Stroke Scale (NIHSS). We followed the participants for a median of 3 months using a standard questionnaire to determine the stroke recurrence events. The correlation analysis and multiple linear regression analysis were performed. Compared with controls, serum Lp(a) levels were significantly increased in ischemic stroke patients than in controls. NIHSS scores and infarct volume were positively correlated with Lp(a) (P < 0.001). Finally, 34 patients (16.7%; 95% CI, 11.6-21.9%) had a stroke recurrence. Serum Lp(a) levels in patients with recurrent stroke were significantly higher as compared with those in patients without recurrent stroke (P < 0.001). In multivariate analysis, there was an increased risk of stroke recurrence associated with Lp(a) levels ≥300 mg/l (OR, 2.87; 95% CI, 1.98-4.32; P = 0.009) after adjusting for possible confounders. With an AUC of 0.872 (95% CI, 0.816-0.927), Lp(a) showed a significantly greater discriminatory ability to predict stroke recurrence as compared with NIHSS score (AUC, 0.782; 95% CI, 0.704-0.859; P < 0.01). Our findings suggest that elevated serum Lp(a) levels can predict the risk of early stroke recurrence in patients with first-ever ischemic stroke. Further research is needed to replicate these findings.
在中风的发病机制中，炎症起着至关重要的作用。本研究旨在确定血清脂蛋白(a)[Lp(a)]水平，并在急性缺血性中风(AIS)患者的 3 个月随访研究中探讨其与中风复发事件的相关性。在入院时，测定了 203 例缺血性中风患者和 120 例正常对照者的血清 Lp(a)水平。采用国立卫生研究院中风量表(NIHSS)评估缺血性中风患者的严重程度和临床转归。我们使用标准问卷对参与者进行了中位数为 3 个月的随访，以确定中风复发事件。进行了相关性分析和多元线性回归分析。与对照组相比，缺血性中风患者的血清 Lp(a)水平显著升高。NIHSS 评分和梗死体积与 Lp(a)呈正相关(P<0.001)。最后，34 例患者(16.7%;95%CI，11.6-21.9%)发生中风复发。与无复发中风的患者相比，复发中风患者的血清 Lp(a)水平显著升高(P<0.001)。在多元分析中，在校正可能的混杂因素后，Lp(a)水平≥300mg/L 与中风复发的风险增加相关(OR，2.87;95%CI，1.98-4.32;P=0.009)。Lp(a)的 AUC 为 0.872(95%CI，0.816-0.927)，与 NIHSS 评分相比，其预测中风复发的能力具有显著的差异性(AUC，0.782;95%CI，0.704-0.859;P<0.01)。我们的研究结果表明，升高的血清 Lp(a)水平可以预测首次发生缺血性中风患者的早期中风复发风险。需要进一步的研究来复制这些发现。
